1. Advisory Forum November 28th-29th 2005 HIV, AIDS and Other Sexually Transmitted and Blood Borne Infections Prof Angus Nicoll SNE - HIV & STI Co-ordinator

2. Advisory Forum November 28th-29th 2005 Current Disease Status - EU Sustained transmission of HIV in Europe at unacceptably high levels –men having sex with men and injecting drug users –Low but perhaps rising levels of heterosexual HIV transmission Sustained transmission of other blood borne viruses (hepatitis B & C) through drug injecting though seeming recent falls in HIV transmission in Eastern Member States Major success of HIV treatment but hence rising prevalence and other secondary problems e.g. Antiviral resistance A partial success – dramatic reduction in HIV infections in babies since the mid 1990s Recent rises in gonorrhoea rates in a number of countries especially in adolescents and young adults Potential health gain through screening for and treating chlamydia especially in women

3. Advisory Forum November 28th-29th 2005 Groups for Targeting –Men who have sex with men –Injecting drug users –Heterosexual Men and Women those at risk of acquiring their infection in Europe those who have acquired the infection in countries where HIV transmission is more intense (notably Sub Saharan Africa) –Persons who have received infected blood and other body products –Babies being born HIV infected women

4. Advisory Forum November 28th-29th 2005 Consequences of the Successful Treatment of HIV & AIDS –Many people living productive lives despite having HIV infection –Treatment costs of HIV are steadily mounting making HIV probably the most costly chronic infection in Europe –Number of people living with HIV infection are also steadily increasing with an unknown effect on HIV transmission –Possible effects on behaviours. Some findings suggesting that the awareness of treatment is supportive of more risky sexual behaviours, especially among men having sex with men

5. Advisory Forum November 28th-29th 2005 Recent European Documents United Nations special sessions on AIDS 2001 onwards http://www.unaids.org/en/events/un+special+session+on+hiv_aids.asp Dublin Declaration 2004 http://europa.eu.int/comm/health/ph_threats/com/aids/docs/dublin_decl.pdf Vilnius Declaration 2004 http://europa.eu.int/comm/health/ph_threats/com/aids/docs/ev_20040916_rd03_en.pdf Coordinated and Integrated Approach to Combat HIV/AIDS within the European Union and in its Neighbourhood 2004 http://europa.eu.int/comm/health/ph_threats/com/aids/docs/ev_20040916_rd01_en.pdf Commission Draft Commuication and Action Plan 2006-2009

6. Advisory Forum November 28th-29th 2005 Dublin and Vilnius Declarations on Partnership to fight HIV/AIDS in Europe and Central Asia Key Themes: –Leadership –Prevention –Living with HIV-AIDS –Partnerships: civil society, NGOs, CBOs, UNAIDS, European Union –Improving access to antiretrovirals –Improving surveillance –”Ensuring activities of ECDC reinforce and coordinate existing surveillance” –Follow-up in 2006

7. Advisory Forum November 28th-29th 2005 Status of Surveillance Competent enhanced surveillance for HIV but outputs not used for policy and practice No enhanced surveillance for other blood borne viruses ’Young’ enhanced surveillance for acute STIs No secure microbiological surveillance for HIV or other blood borne viruses No secure surveillance for antiviral resistance Stakeholders generally data ’blind’

8. Advisory Forum November 28th-29th 2005 Director of ECDC speaking in European Parliament –Early diagnosis, treatment and care for HIV infected to reduce repercussions and further transmission –Effective surveillance especially to target, monitor, evaluate and improve public health intervention –Biological surveillance supplemented by behavioural surveillance –New campaigns targeting young people and groups who practice partner change –New campaigns targeting men who have sex with men –Campaigns for sex workers –Prevention, care, treatment for migrants and immigrants

9. Advisory Forum November 28th-29th 2005 What will be the Initial Actions by ECDC? HIV & AIDS one of our four priority disease areas. Discussions with Commission and EuroHIV to use established coordination structures to determine how ECDC can complement their activities after the Dublin and Vilnius Declarations ECDC-EuroHIV press on HIV & AIDS in November An ad hoc Scientific Panel on HIV & AIDS, STIs and blood borne viruses Intended Meeting with the European Member States to take stock of where we are in Europe A broader programme of work will be identified across the Centres Units and presented to the Advisory Forum at its meeting in February 2006.

10. Advisory Forum November 28th-29th 2005 What we are asking the Advisory Forum? What has been the impact of the Dublin and Vilnius Declarations in their countries? The role for ECDC in working with the Commission and others to revitalise HIV surveillance and prevention in Europe and to better link surveillance data to policy and practice - particularly in the light of the Draft Action Plan Proposed by the Commission? The interim recommendation to combine ECDC work on HIV and AIDS with that on other sexually transmitted and blood borne viral infections (hepatitis B and C)?